| Abstract: | SUMMARY The relation between quality of life before admission and theoutcome of admission to the intensive care unit (ICU) was studiedprospectively among 126 patients in a community hospital witha predominantly geriatric patient population. Fifty-four percent of our patients were older than 65 years and 66 per centsuffered from chronic ill health. Their mean APACHE score was18±8 (mean±SD). Quality of life was assessed bythe Karnofsky index of physical performance; the linear analogueself assessment (LASA) score; sleep index; level of employment;sexual activity; housing status. Thirty-seven per cent of thepatients died in ICU and another 10 per cent in hospital. Theone year survival of the entire group was 37 per cent. Survivalrates were significantly higher in patients with a Karnofskyindex of 6 or more, LASA score of 55 or more, in employment,and with sleep index of 2 or more (p<0. 05). The 12-monthsurvival among patients with four favourable indicators was59 per cent, with two or three favourable indicators 36 percent (p<0. 05), and in patients with no favourable indicatorsof quality of life or only one 17 per cent (p<0. 001). Qualityof life in patients who survived longer than six months afterICU care was high (Karnofsky index 7. 9±2.0; LASA score71±20 (mean±SD) and unimpaired when compared withtheir ratings before admission to the unit. These findings indicatethat quality of life before admission is an important predictorof survival and that a high proportion of critically-ill subjectswhose quality of life was relatively good before the episoderequiring admission will be long-term survivors whose qualityof life is comparable to that preceding critical care. |
